Elizabeth Southard, LMHC, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

ELIZABETH SOUTHARD, LMHC, LLC

Practice address

690A W Macclenny Ave
Macclenny, FL 32063-2080

Phone

(904) 400-0517

NPI assigned

Aug 22, 2020

Last updated

Apr 17, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mary Elizabeth Southard, LMHCNPI 1164810867

Title

Owner

Phone

(904) 400-0517

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Elizabeth Southard, LMHC

  • Mental Health Counselor
  • Macclenny, FL
  • NPI 1164810867
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618617600000",
    "number": "1841802683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5570 HUCKLEBERRY TRL N",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320631803",
            "telephone_number": "904-885-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690A W MACCLENNY AVE",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632080",
            "telephone_number": "904-400-0517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH SOUTHARD, LMHC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-22",
        "last_updated": "2021-04-17",
        "certification_date": "2021-04-17",
        "status": "A",
        "authorized_official_last_name": "SOUTHARD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-400-0517",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021509900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Dyer
• Robin Eaddy
• Jane Ellen Echterling, PH.D.
• Bradley James Edwards, RN
• Tina Louise Edwards
• Cristin Ellis
• Alexandra Erbesti
• Alanna D Eubanks, RD, LD/N
• Tara Evans
• Danielle Grace Fender

• Mental Health Counselor in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.